Physician-assisted suicide is threatening to replace the credit crunch as the number one hot button topic of the day.
Physician-assisted suicide is threatening to replace the credit crunch as the number one hot button topic of the day. The televised death of Craig Ewert, a motor neurone disease sufferer, has understandably provoked an intense debate. Here in Scotland, the doughty Lothians MSP Margo MacDonald, who suffers from Parkinson's disease, has told the Scottish Parliament she wants the right to end her own life at a time of her choosing.
Physician-assisted suicide occurs when a person wishing to die takes their own life with the indirect help of a doctor, for instance by providing prescription drugs. Voluntary euthanasia involves direct intervention by another person: you ask me to smother you and I oblige. (Probably not on live television, with slow-motion highlights screened later.) There are two very clear-cut positions on this difficult issue. One says that the role of doctors must always be to preserve human life and never to seek to end it. While this view is often described as a religious position, it is supported by the British Medical Association and several disability charities. The other position argues that we treat dogs more humanely than suffering human beings and that doctors should assist patients who, when in sound mind, request an exit.
Having been present at a few death beds - and more recently spent some time with a friend dying of motor neurone disease - I have a great deal of sympathy for the arguments in favour of legislation to permit, under certain conditions, assisted suicide. I also have personal admiration for Margo MacDonald as a politician and a human being. If we are in pain, shouldn't we be able to ask our doctor to put us out of our misery? The truth is that doctors sometimes do just that, knowing that increasing the level of morphine to the point at which it will adequately deal with agonising pain will tip the terminal patient in the direction of a hastened death. The moral territory gets even trickier when we consider the new technologies which can keep us alive long after we have passed our sell-by date. Pneumonia, "the old person's friend", used to be a natural, blessed release; now, machines can keep us in the land of the living even when we are, to all intents and purposes, dead.
Despite the passionate and heart-felt arguments for legalising assisted suicide, I want to argue against it. Despite its merciful intentions, such a move would create an ultimately uncontrollable environment in which vulnerable people would be at risk. Relatives burdened by care and costs - or lusting after inheritances - would be tempted to insist that death was what granny wished. The conscientious elderly might feel obliged to make for the exit door to please their busy children, or to avoid being a burden on the state.
Anyone who has glimpsed even a small segment of the slaughterhouse of the twentieth century should be under no illusions about the human capacity for evil. Nor is religion per se the answer. Christian German officers at Auschwitz went home to put Beethoven on the turntable and play with their children. I do not trust the state. I do not trust bureaucracies. With our current lethal tendency to commodify everything, when the next credit crunch comes along, will there be targets for the culling of the inconvenient elderly? I exaggerate, of course: cultural change for the worse happens much more insidiously. Read Orwell.
And here's the rub: physician-assisted suicide implicates other people. The doctor has to prepare the deadly prescriptions. I do not want to wonder whether my friendly GP actually intends to kill me. In times of extremity, I don't want my physician to morph into Harold Shipman.
Is that scare-mongering? Probably, but there are some scares worth mongering. You don't have to agree with the doctrine of the sacredness of life to see that without a moral rootedness in the non-negotiability of the human, it is all too easy to slip into a utilitarian culture of death. I fear that the current enthronement of the choices of the individual adult - which is as questionable a "world view" as any religious position - takes us down a dangerous road.
I fully recognise that it is much easier to discuss this issue in terms of first principles, deities and demons than to face the suffering of a human being one loves. What I would like to see is the palliative care lessons learned in hospices being incorporated into the mainstream. Now that would be costly compassion on a wide scale.
I like the poet Arthur Hugh Clough's "Thou shalt not kill but needs not strive, officiously, to keep alive". There is a moral distinction between clinically-justified processes that may hasten death and the deliberate taking of life. There are some lines a civilised society should not cross.
